The diagnostic value of FNAC in cervical lymphadenopathy

Abstract

Background. Fine-needle aspiration cytology (FNAC) is the basic investigation that can be performed even in small centers, with low costs, without major complications and with good patient compliance. The broad spectrum of diseases can be classified into inflammatory conditions, malignancies or lymphoma, which allows the planning of the treatment strategy or further investigation that is necessary for diagnosis. Materials and Methods. A prospective study was performed on 100 individuals with enlarged cervical lymph nodes who underwent FNAC and surgery, from 2017 to 2019. The histopathological reports of the patients were correlated with the preoperative cytological reports. Results. Of the studied cases, reactive lymphadenopathy was the most common - 43%, followed by tuberculous lymphadenopathy - 21%, granulomatous lymphadenopathy - 16%, and malignancy - 16%. Among malignancy, the most common is the secondary from squamous cell carcinoma – 11 cases (68.75%) followed by metastasis from thyroid carcinoma – 4 cases (25%) and metastasis from adenocarcinoma – 1 case (6.25%). By the age of 40, the most common malignancy is metastasis from thyroid carcinoma, while over 40, the secondary tumor from squamous cell carcinoma is the most common. Sensitivity, specificity and accuracy of FNAC are high in carcinomatous (93.75%, 100%, 99%), lymphomatous (75%, 98.96%, 98%) and tuberculous lymphadenopathy (95.24%, 96.20%, 96%). Conclusions. FNAC is a simple and safe test, with a good accuracy of diagnosis and low complications, being therefore an effective diagnostic tool.

Keywords

• cervical lymphadenopathy
• fnac
• histopathology
• sensitivity
• specificity